This invention relates to cabinets for storing and dispensing prescription medical items, and is more particularly concerned with a cart or rolling cabinet which can be wheeled into a surgical room and which can provide an anesthesiologist with full access to the contents, but can also provide security in respect to narcotics and other controlled materials contained in the cart. Importantly, the invention is also directed to an anesthesia cart which has the ability to lock automatically when the anesthesiologist is not present, e.g., when the anesthesiologist walks away from the cart.
Medications, including narcotics, sedatives, and other controlled substances, are routinely used by an anesthesiologist in the operating room. These substances need to be freely available to the anesthesiologist in an emergency situation where time is of the essence. At the same time, because these controlled substances have high potential for abuse, the compartments that contain these substances have to be secured and locked at any time the anesthesiologist is not present. These two goals are mutually contradictory, where the need to keep these substances secure and locked up interferes with the need to make the materials fully available in an emergency.
The anesthesia carts and other medications carts currently available typically involve a mechanical lock that has to be physically unlocked to obtain access to the contents. These carts need a physical key to unlock the compartments to obtain access. This can be a detriment to the objective of free access if the key cannot be found for some reason, and can be a detriment to security of the controlled materials if the user forgets to re-lock the cart. Also, the key access system does not allow for obtaining the identification of the person opening the cart. Those carts also lack the capability for a sophisticated audit trail, so that it is not possible to determine or record who it was that accessed the cart, when it was opened, when it was locked, and what item(s) have been removed from the cart or cabinet.
Some cabinets and carts permit electronic locking and unlocking, and have the capability of maintaining an audit trail of access. However, these carts depend for security of the contents on the user's affirmative input to lock the cart, or a timer that automatically sets to relock the cart after some fixed time period (e.g., ten minutes) after the cart is accessed and opened or unlocked. The deficiency of the former system is that if the user forgets or neglects to re-lock the cart, then the cart does not secure the contents. The deficiency of the latter system is that the cart may automatically re-lock during a surgical procedure, locking the anesthesiologist out, and delaying the access to emergency drugs, as they become at least temporarily unavailable pending re-logging into the cart and re-entering the anesthesiologist's access or PIN number. The use of an access card may assist in reducing the time needed to re-log in, but even then reaching for the card and swiping it in the cart can waste valuable time in an emergency, and as for narcotics or other controlled materials, security requirements mean that an additional password or code would still need to be entered to resume access.